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NIP, TUCK . . . TELL?

Did she or didn't she? We've all engaged in a

snark-fest at one time or another, trying to guess if a certain film or

television star has had "work" done. And while some, such as Kathy Griffin,

Joan Rivers and Patricia Heaton, have been way public about their cosmetic

surgeries, the majority opt to keep such procedures secret. After all, our pop

culture celebrities tend to have a vested interest in maintaining certain

physical illusions.

But the rich and famous are not the only ones going under the knife. There

were 11.6 million cosmetic procedures done in the United States in 2006,

according to the American Society for Aesthetic Plastic Surgery, up by 446

percent since 1997, when it began compiling statistics. The most popular

procedure last year for men and women was Botox injections. Liposuction was the

most frequently performed surgery. For women, however, breast augmentation

topped the list, followed closely by liposuction.

With so many of us undergoing elective enhancement these days, should we

reveal our choice to friends, neighbors, co-workers, relatives - our children?

Sharing the new you

Telling friends and relatives about a cosmetic procedure is a highly

personal decision, says Dr. Z. Paul Lorenc, a cosmetic surgeon with a practice

on Park Avenue in Manhattan. But that decision is frequently affected by the

type of procedure a patient is having.

For instance, highly popular and minimally invasive Botox or Restylane

injections are simple and quickly administered procedures that require an

office visit and virtually no recuperative downtime. A "lunch-hour makeover"

can therefore yield subtle and natural-looking results that other people may

not even notice.

"Surgery is a different story," says Dr. Steven Pearlman, who specializes

in facial plastic surgery in his Manhattan practice. "That's a major decision

that requires undergoing anesthesia. It's exceedingly safer than it was 30

years ago, but surgery requires healing." That means the patient will need

physical and emotional support from a spouse, relative or friend during

recovery, so telling someone, at least for that very purpose, is recommended by

all doctors of cosmetic surgery.

But that's not why Stacy Abrams of Merrick told her friends about the

breast augmentation and abdominoplasty (tummy tuck) she underwent last year. "I

tell everyone. I'm all for it," says the 40-year-old mom of two who's also had

Botox and Radiesse (a dermal filler) treatments for her face. "It's so widely

accepted now, you read about it in almost every magazine."

Television makeover shows such as "The Swan," "Extreme Makeover" and "Dr.

90210" have popularized cosmetic surgery to the point where the taboo element

has practically vanished, adds Abrams' surgeon, Dr. David Funt, who has

practices in Woodmere and Garden City.

"For most women, it's not a taboo; they're happy to share it with people,"

Pearlman says. This is particularly the case when the results are a

dramatically enhanced appearance.

"I couldn't stand the way I looked," confesses 59-year-old Connie Alibrandi

of East Northport. Once she decided to have cosmetic surgery, she thought

she'd keep it to herself out of sheer embarrassment. But after her face-lift,

she developed a heightened sense of self-confidence.

"It changes your whole personality, your self-esteem," she says happily,

and now she readily comes clean to anyone who comments on her younger

appearance. What's more, Alibrandi says she hasn't had any negative comments or

felt judged by anyone she's told.

Will they accept it?

Acceptance by one's peers can be a determining factor when deciding whether

to tell or not to tell about plastic surgery. "My friends are in their 30s to

50s and, for my contemporaries, it's normal to talk about it," Abrams says,

adding that a number of her friends have had breast augmentation while others

are considering it.

Based on the television makeover programs and reality dating shows, hiding

voluptuously enhanced breasts is the last thing women who've undergone

augmentation surgery desire to do. But that's show business. In Wendy Lewis'

real-life experience, she finds her clients who want their breasts done don't

want "porn-star boobs." Known as The Knife Coach, Lewis is a New York-based

independent cosmetic surgery concierge of sorts who counsels patients

contemplating plastic surgery. "My clients want what they used to have; soccer

moms from Great Neck, for example, who just had a second baby and would like

their original fullness and volume back" in their breasts.

That is exactly what Abrams wanted from her augmentation. And although

she's been candid about it, "I didn't want it to be obvious," she says.

Sometimes, we think keeping a secret isn't an option. Laura Ellick, a

psychologist with a private practice in Kings Park, says she had no qualms

about telling people about her procedure. "I had a deviated septum and lived

with it for ages. I never liked my nose, and my breathing problems got bad,"

the 36-year-old says. Finally, two years ago, she had rhinoplasty surgery.

"Recovery was pretty quick; I stayed out of work for a week," she says.

Regarding the results, "I feel much better. I don't have to worry about it

anymore.... It's pretty subtle, and it sort of shows me the flaws we think are

wrong with ourselves are magnified dramatically."

Before her surgery, she says, "nobody focused on my nose except me."

And afterward? She says nobody noticed.

Of course, that doesn't mean the people she hasn't directly told about her

nose job haven't been playing the speculation game. ...

What your kids need to know

It's one thing to tell adults about an elective cosmetic surgery procedure.

It's quite another communicating that to your children. And while younger ones

don't need to know the gritty details, there are ways to prepare them.

"Keep it light and simple," suggests Dr. Steven Pearlman, who has a facial

plastic surgery practice in Manhattan.

"Children can get scared, and it's easier for a child to be told up front,

versus coming home from school and being told that Mommy can't get out of bed,"

says Dr. Z. Paul Lorenc, a clinical professor of plastic surgery at New York

University's School of Medicine.

But you don't have to be specific on the details. A simple "Mommy has a

boo-boo" should suffice for very young kids, Pearlman adds.

With older children, a conversation is called for, the experts agree.

Explain that you have made a personal choice and that you would like family

support. As long as you present a healthy attitude about your desired changes -

that is, you are neither ashamed nor embarrassed about your decision, there

is no reason your children will be.

- Claudia Gryvatz Copquin

When you want to keep it private

While undergoing cosmetic surgery no longer has the social stigma of

yesteryear, it is possible to keep it a private matter. Tips from the pros

include:

Have a procedure in the winter, when people are prone to staying indoors

(less public visibility) and wearing more clothing to cover healing wounds.

After a procedure, redirect attention to another part of your appearance.

For instance, cutting your hair in a new style after a facial procedure can

throw people off the surgery-sniffing track.

If you don't want obvious results, don't wait until you're visibly aged to

have a procedure. According to the American Society for Aesthetic Plastic

Surgery, 47 percent of cosmetic procedures are done by people ages 35 to 50.

For subtle results, make small changes with less-invasive procedures, in

well-spaced time frames.

Plan a long vacation from work for maximum recuperation from facial

surgery. You'll appear rested and refreshed upon your return. And don't have

surgery over holidays, which are prime time for social gatherings.

If you're having breast implants, resist going from an A-cup to a D-cup or

larger.

If people ask, you don't have to reveal every procedure you've had. Naming

just one is an acceptable response. The rest can remain private.

- Claudia Gryvatz Copquin

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